Chapter 5: Exercise and Older Adults 2 Contact Hours
By: Lisa Augustyn, PT, DPT Learning objectives
After completing this course, the learner will be able to: Describe how aging affects the musculoskeletal system, cardiovascular system, pulmonary system, height, weight, and activity level. Discuss fall-prevention strategies for older adults and how aging increases the risk of falls. Describe how physical and occupational therapists can help to educate and treat older patients who are at risk for falls. Develop a safe and effective exercise program for the elderly population. Course overview Between 2000 and 2050, the worldwide population of those 60 and older is projected to double from about 11 to 22 percent, increasing from 605 million to 2 billion (Bjermo et al., 2012). By the year 2030, it is estimated that 20 percent of the U.S. population will be older than 65 (U.S Department of Health and Human Services, 2015). The effects of aging impact all body systems. Today’s older adult population is generally more active than previous generations, which can help to offset the effects of aging. Exercise can be a safe and effective way to counteract the changes that occur with aging, and there are plenty of benefits to staying active. Falls in the elderly are considered one of the most serious and expensive public health problems in terms of morbidity, mortality and costs to health and social services (Ishigaki et al.,
Develop exercise programs for special patient populations, including frail older adults, with conditions that are common among older adults,such as chronic heart failure, arthritis, diabetes, sarcopenia, peripheral arterial disease, cardiovascular disease, pulmonary disease,osteoporosis, hypertension and obesity. Describe specific types of exercise that improve functional outcomes for older adults including strength training, balance training, PNF,Pilates, tai chi and aerobic exercise. Discuss the long-term effects of exercise in the older adult population. 2014). Worldwide, an estimated 424,000 people die each year from falls; the vast majority are from low- and middle-income countries (Ishigaki et al., 2014). Additionally, an estimated 37.3 million falls require medical attention (Ishigaki et al., 2014). Physical and occupational therapists also play an important role in decreasing the risk of falls in the elderly population. They can effectively develop exercise programs for the aging population and for special populations with specific diseases or conditions. These prescribed programs can improve an aging person’s functional activity levels, which can be seriously impacted by a fall, causing serious health consequences. Fall-prevention strategies can help decrease the risk of falls and improve overall health and functional ability in the aging population.
THE EFFECTS OF AGING ON THE BODY
Aging is associated with declines in the neuromuscular, cardiovascular, musculoskeletal, hormonal and pulmonary systems. Aging can also cause changes in hormones and the integumentary system, as well as a progressive decline in skeletal muscle mass leading to sarcopenia (Strandberg et al., 2015). The loss of muscle mass, the decline in muscle strength and the decline in muscle power – especially in the lower limb muscles – can cause a decline in functional activity (Strandberg et al., 2015). Sarcopenia is age-related muscle loss that occurs in the older adult population and can also lead to a functional decline (Mangione et al., 2016). Men lose muscle more gradually than women, who have a more dramatic decrease after menopause (Mangione et al., 2016). With increasing age, muscle loss due to sarcopenia becomes a problem (Mangione et al., 2016). According to the National Health and Nutrition Examination Survey, an estimated 35 percent of older adults had moderate sarcopenia, whereas 10 percent had severe sarcopenia (Mangione et al., 2016). The loss of muscle strength and muscle mass is prevalent among the older adult population, so it is important to consider the impact it can have on an older adult, including loss of function and an increase risk of falls. Parameters associated with an increased risk of falls include impairment of muscle strength and power of the lower extremities; impairment of balance/postural control; and impairment of walking ability (Kawanabe et al., 2007). These parameters are known to become progressively more impaired with aging (Kawanabe et al., 2007). Age-related decreases in muscle strength and power are more prevalent in the lower extremities (Kawanabe et al., 2007). After age 70, a person loses about 1.5 percent of muscle mass per year (Krist et al., 2013). Older adults can be affected by joint injuries, arthritis,
osteoporosis, and an increased risk of falls, which can lead to fractures. Lack of physical activity in older adults can contribute to many chronic illnesses, such as heart disease, stroke, diabetes mellitus, lung disease, Alzheimer’s disease, hypertension and cancer (Elsawy et al., 2010). Lack of physical activity, combined with poor dietary habits, can contribute to an increase in obesity in the older population (Elsawy et al., 2010). Older adults in the U.S. do not typically achieve the recommended minimum amount of physical activity, which can contribute to declining function and an increased risk of disease (Elsawy et al., 2010). Regular physical activity has beneficial effects on a variety of health conditions. There is strong evidence that physical activity decreases the risk of an early death, heart disease, stroke, Type-2 diabetes mellitus, high blood pressure, adverse blood lipid profile, metabolic syndrome, and colon and breast cancer (Elsawy et al., 2010). There is also strong evidence that physical activity can prevent weight gain, contribute to weight loss when combined with a healthy diet, improve cardiorespiratory and muscular fitness, reduce depression, improve cognitive function in older adults and aid in fall prevention (Elsawy et al., 2010). Moderate to strong evidence shows physical activity can help to improve functional health and reduce abdominal obesity in older adults (Elsawy et al., 2010). Moderate evidence shows physical activity can help with weight maintenance after weight loss, decrease risk of a hip fracture, increase bone density, improve sleep quality and decrease the risk of lung and endometrial cancers (Elsawy et al., 2010). Adults who are physically active have a lower risk of mental health changes/disease which includes depression and cognitive decline when compared to inactive adults (Elsawy et al., 2010). Overall, exercise provides
Page 80
Book Code: PTNY3622B
EliteLearning.com/Physical-Therapy
Powered by FlippingBook